Individual
JENNIFER J KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
14 ELLIS POTTER CT, MADISON, WI 53711-2478
(608) 234-5990
Mailing address
2013 CARDINAL WAY, WAUNAKEE, WI 53597
(608) 850-9073
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4060026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40861300
—
WI
Enumeration date
05/06/2006
Last updated
07/02/2012
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